Bio

Bio


Dr. Enemchukwu received her undergraduate degree from Duke University. She subsequently earned her combined degree in Medicine (MD) and Public Health (MPH) at the University of North Carolina School of Medicine and Gillings School of Global Public Health. She completed her General Surgery and Urology training at Vanderbilt University Medical Center. She then went on to complete a prestigious fellowship in Female Pelvic Medicine & Reconstructive Surgery with concurrent training in Male Voiding Dysfunction and Neurourology at NYU Langone Medical Center in New York City.

She specializes in medical and minimally invasive surgical management of male and female conditions, including pelvic organ prolapse (cystocele, rectocele, vaginal vault prolapse, and uterine prolapse repairs, including concurrent vaginal hysterectomy), female genitourinary fistula, urinary tract infection, overactive bladder, urinary incontinence, hematuria, urinary retention, mesh complications, refractory fecal incontinence, ureteral strictures and urethral stricture disease (including graft reconstruction). She performs open, robotic, endoscopic and laser surgery. She also specializes in uterine sparing robotic pelvic organ prolapse repair.

Her research interests are in the areas of refractory overactive bladder in elderly/frail, neurogenic and underserved patient populations, detrusor underactivity, quality of life, patient outcomes, quality improvement, patient satisfaction, and shared decision making. Her clinical interests also include International work, with previous outreach projects in Honduras, Uganda and Nigeria.

Clinical Focus


  • Urology
  • Urogynecology
  • Pelvic Organ Prolapse
  • Neurogenic Bladder
  • Urinary Incontinence

Academic Appointments


Administrative Appointments


  • Director, Urology at Pelvic Health Center, Stanford HealthCare (2018 - Present)

Honors & Awards


  • Aimee Gibson Memorial Scholarship, UNC School of Medicine (2003-2008)
  • Loyalty Fund Full Tuition Scholarship, UNC School of Medicine (2004-2008)
  • Mayer Community Service Honor Society Inductee, UNC School of Medicine (2005)
  • American Urological Association Traveling Fellowship Award, Society for the Study of Male Reproduction (SSMR)/Sexual Medicine Society (SMS) (2011)
  • Resident Mentorship Conference Travel Award, Society of Women in Urology (SWIU) (2012)
  • Careers in Academic Medicine Workshop Travel Award, NIH/NIDDK/NMA (2013)
  • HCOE Faculty Development Research Award, Stanford University (2015)
  • Stanford School of Medicine Teaching Award Nominee, Stanford School of Medicine (2017)

Boards, Advisory Committees, Professional Organizations


  • Member, American Urogynecologic Association (AUGS) (2013 - Present)
  • Member, Vanderbilt Urology Society (VUS) (2013 - Present)
  • Member, Society of Women in Urology (SWIU) (2012 - Present)
  • Member, American Urological Association (AUA) (2009 - Present)
  • Affiliate Member, Society of Urodynamics and Female Urology (SUFU) (2009 - Present)

Professional Education


  • Fellowship, NYU Langone Medical Center, Departments of Urologic Surgery and Obstetrics & Gynecology, NY, Female Pelvic Medicine and Reconstructive Surgery (2015)
  • Residency, Vanderbilt University Medical Center, Department of Urologic Surgery, Urology (2013)
  • Internship, Vanderbilt University Medical Center, Department of General Surgery, General Surgery (2009)
  • MD, University of North Carolina School of Medicine (2008)
  • MPH, University of North Carolina Gillings School of Global Public Health (2008)
  • BS, Duke University (2002)

Community and International Work


  • Kagando Hospital Outreach, Kenya and Uganda

    Topic

    BPH/Fistula Repair

    Partnering Organization(s)

    AMREF

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Research & Scholarship

Current Research and Scholarly Interests


Refractory overactive bladder in elderly and frail patient populations, detrusor underactivity, quality of life, patient outcomes, quality improvement, patient satisfaction, and shared decision making

Teaching

2018-19 Courses


Graduate and Fellowship Programs


  • Adult Reconstruction (Fellowship Program)

Publications

All Publications


  • Outcomes of Sacral Nerve Stimulation for Treatment of Refractory Overactive Bladder Among Octogenarians. Neuromodulation : journal of the International Neuromodulation Society Greenberg, D. R., Syan, R., Young-Lin, N., Comiter, C. V., Enemchukwu, E. 2019

    Abstract

    OBJECTIVE: Sacral nerve stimulation (SNS) is an effective treatment for refractory overactive bladder (OAB). However, advanced age is often cited as a reason to avoid SNS in the elderly. This study evaluates the safety and efficacy of SNS for refractory OAB among our octogenarian population.METHODS: A retrospective review from a single institution was performed on all SNS lead placements from December 1998 to June 2017 for refractory OAB. Octogenarians were characterized as 80years of age or older at the time of Stage I. Efficacy and safety were determined by the rate of progression to Stage II, subsequent need for multimodal therapy, and rate of surgical revision and explantation. All patients were followed for a minimum of 12months.RESULTS: Of 374 patients in this study, 37 (9.9%) were octogenarians. There was no difference in gender, race, smoking history, or prior OAB treatment regimens between cohorts. The rate of progression to Stage II was 56.8% for octogenarians compared to 60.5% for nonoctogenarians (p = 0.66). The rate of surgical revision, explantation, and need for multimodal therapy did not differ between groups. Subgroup analysis of octogenarians did not reveal any significant differences between successful and nonsuccessful Stage I patients.CONCLUSIONS: The safety and efficacy of SNS was similar between cohorts. This result suggests that SNS is a safe and effective therapy that should be considered among the treatment options for refractory OAB in octogenarian patients. Further studies are needed to determine predictive factors of Stage I success in elderly patients.

    View details for DOI 10.1111/ner.12981

    View details for PubMedID 31215713

  • Sacral neuromodulation in Parkinson's disease patients with neurogenic bladder Greenberg, D., Sohlberg, E., Zhang, C., Comiter, C. V., Enemchukwu, E. WILEY. 2019: S158–S159
  • Exploring the bowel and bladder dysfunction relationship in a multiple sclerosis population Jericevic, D. K., Peyronnet, B., Rude, T., Enemchukwu, E., Palmerola, R., Sussman, R., Pape, D., Rosenblum, N., Sammarco, C., Zhovtis-Ryerson, L., Kister, I., Howard, J., Krupp, L., Brucker, B. WILEY. 2019: S125–S126
  • Numerous socioeconomic and ethnic factors predict receiving advanced OAB therapies in a commercially insured population Syan, R., Zhang, A., Enemchukwu, E. WILEY. 2019: S75–S76
  • Prophylactic midurethral slings at the time of pelvic organ prolapse repair surgery to prevent de-novo stress urinary incontinence-a need to reappraise? Dallas, K. B., Rogo-Gupta, L., Syan, R., Enemchukwu, E., Elliott, C. S. WILEY. 2019: S70–S71
  • Transvaginal Suture-Based Repair. The Urologic clinics of North America Enemchukwu, E. A. 2019; 46 (1): 97–102

    Abstract

    An estimated 300,000 women undergo pelvic organ prolapse (POP) surgery in the United States every year at a cost of more than 1 billion dollars per year. The prevalence of POP is approximately 2.9% to 8%, and increases with age. Apical support is required to achieve successful prolapse repair. As the search for the safest, most durable, surgical repair continues, transvaginal native tissue repairs have the advantage of providing minimally invasive surgical repairs without the added risk of abdominal, laparoscopic, or robotic surgery while avoiding the risk of mesh augmentation.

    View details for PubMedID 30466707

  • Basic Evaluation of the Patient with Pelvic Floor Dysfunction Challenging Clinical Scenarios in Female Pelvic Medicine Syan, R., Enemchukwu, E., Dobberfuhl, A., Comiter, C. Springer International Publishing. 2019
  • Association Between Concomitant Hysterectomy and Repeat Surgery for Pelvic Organ Prolapse Repair in a Cohort of Nearly 100,000 Women. Obstetrics and gynecology Dallas, K., Elliott, C. S., Syan, R., Sohlberg, E., Enemchukwu, E., Rogo-Gupta, L. 2018

    Abstract

    OBJECTIVE: To evaluate the association of hysterectomy at the time of pelvic organ prolapse (POP) repair with the risk of undergoing subsequent POP surgery in a large population-based cohort.METHODS: Data from the California Office of Statewide Health Planning and Development were used in this retrospective cohort study to identify all women who underwent an anterior, apical, posterior or multiple compartment POP repair at nonfederal hospitals between January 1, 2005, and December 31, 2011, using Current Procedural Terminology and International Classification of Diseases, 9th Revision procedure codes. Women with a diagnosis code indicating prior hysterectomy were excluded, and the first prolapse surgery during the study period was considered the index repair. Demographic and surgical characteristics were explored for associations with the primary outcome of a repeat POP surgery. We compared reoperation rates for recurrent POP between patients who did compared with those who did not have a hysterectomy at the time of their index POP repair.RESULTS: Of the 93,831 women meeting inclusion criteria, 42,340 (45.1%) underwent hysterectomy with index POP repair. Forty-eight percent of index repairs involved multiple compartments, 14.0% included mesh, and 48.9% included an incontinence procedure. Mean follow-up was 1,485 days (median 1,500 days). The repeat POP surgery rate was lower in those patients in whom hysterectomy was performed at the time of index POP repair, 3.0% vs 4.4% (relative risk [RR] 0.67, 95% CI 0.62-0.71). Multivariate modeling revealed that hysterectomy was associated with a decreased risk of future surgery for anterior (odds ratio [OR] 0.71, 95% CI 0.64-0.78), apical (OR 0.76, 95% CI 0.70-0.84), and posterior (OR 0.69, 95% CI 0.65-0.75) POP recurrence. The hysterectomy group had increased lengths of hospital stay (mean 2.2 days vs 1.8 days, mean difference 0.40, 95% CI 0.38-0.43), rates of blood transfusion (2.5% vs 1.5, RR 1.62, 95% CI 1.47-1.78), rates of perioperative hemorrhage (1.5% vs 1.1%, RR 1.32, 95% CI 1.18-1.49), rates of urologic injury or fistula (0.9% vs 0.6%, RR 1.66, 95% CI 1.42-1.93), rates of infection or sepsis (0.9% vs 0.4%, RR 2.12, 95% CI 1.79-2.52), and rate of readmission for an infectious etiology (0.7% vs 0.3%, RR 2.54, 95% CI 2.08-3.10) as compared with those who did not undergo hysterectomy.CONCLUSION: We demonstrate in a large population-based cohort that hysterectomy at the time of prolapse repair is associated with a decreased risk of future POP surgery by 1-3% and is independently associated with higher perioperative morbidity. Individualized risks and benefits should be included in the discussion of POP surgery.

    View details for PubMedID 30334856

  • Rates and Risk Factors for Future Stress Urinary Incontinence Surgery After Pelvic Organ Prolapse Repair in a Large Population Based Cohort in California. Urology Syan, R., Dallas, K. B., Sohlberg, E., Rogo-Gupta, L., Elliott, C. S., Enemchukwu, E. A. 2018

    Abstract

    OBJECTIVES: To determine the rate and risk factors for future stress incontinence (SUI) surgery in a large population based cohort of previously continent women following pelvic organ prolapse (POP) repair without concomitant SUI treatment.METHODS: Data from the Office of Statewide Health Planning and Development (OSHPD) was used to identify all women who underwent anterior, apical or combined antero-apical POP repair without concomitant SUI procedures in the state of California between 2005-2011 with at least one-year follow-up. Patient and surgical characteristics were explored for associations with subsequent SUI procedures.RESULTS: Of 41,689 women undergoing anterior or apical POP surgery, 1,504 (3.6%) underwent subsequent SUI surgery with a mean follow-up time of 4.1 years. Age (OR 1.01), obesity (OR 1.98), use of mesh at the time of POP repair (OR 2.04), diabetes mellitus (OR 1.19), White race and combined antero-apical repair (OR 1.30) were associated with an increased odds of future SUI surgery.CONCLUSIONS: The rate of subsequent surgery for de novo SUI following POP repair on a population level is low. Patient and surgical characteristics may alter a woman's individual risk and should be considered in surgical planning.

    View details for PubMedID 30222995

  • DO HEALTH DISPARITIES EXIST IN THE INSURED REFRACTORY OAB PATIENT POPULATION? Syan, R., Zhang, C., Enemchukwu, E. WILEY. 2018: S223–S224
  • Current Role of Urethrolysis and Partial Excision in Patients Seeking Revision of Anti-Incontinence Sling. Female pelvic medicine & reconstructive surgery Drain, A., Enemchukwu, E., Shah, N., Syan, R., Rosenblum, N., Nitti, V. W., Brucker, B. M. 2018

    Abstract

    OBJECTIVES: Stress urinary incontinence is highly prevalent and sling surgery has increased since 2000. Urethrolysis traditionally had been standard management of complications after anti-incontinence surgery; however, partial excision is a less aggressive option. This study describes the different populations in a contemporary cohort that undergo sling excision and urethrolysis and their surgical outcomes.METHODS: Chart analysis was performed on patients assigned Current Procedural Terminology codes for removal or revision of sling for stress incontinence, urethrolysis, or revision of graft at our institution from 2010 to 2015. Demographics, indications, outcomes, and subsequent treatment were evaluated.RESULTS: A total of 110 patients underwent surgery and were included. Partial excision was performed on 82 patients and urethrolysis on 28 patients. About 32.7% had prior revision, and median length to revision was 3.1 years. Overall success was 75.0% for urethrolysis and 86.6% for partial excision. Without concomitant sling placement, stress incontinence developed in 25.0% of urethrolysis and 21.6% of partial excision patients. New onset overactive bladder symptoms developed in 21.4% of urethrolysis patients and 7.3% of partial excision, which was significantly different (P = 0.039).CONCLUSIONS: Both approaches had good success, 75.0% for formal urethrolysis and 86.6% for partial excision. New onset urgency was lower for partial excision, but rates of all other complications were similar. These procedures are often used for different patient populations, and thus, outcomes are not meant to be directly compared. Future work on sling revision should report these procedures separately.

    View details for PubMedID 29787462

  • CONCOMITANT HYSTERECTOMY LOWERS THE RATE OF RECURRENT PROLAPSE SURGERY FOR ALL COMPARTMENTS IN A COHORT OF OVER 100,000 WOMEN Enemchukwu, E., Dallas, K., Syan, R., Sohlberg, E., Elliott, C., Rogo-Gupta, L. WILEY. 2018: S556
  • IS PROPHYLACTIC STRESS INCONTINENCE SURGERY NECESSARY AT THE TIME OF PELVIC ORGAN PROLAPSE REPAIR? - RATES OF FUTURE SURGERY IN A LARGE POPULATION BASED COHORT IN CALIFORNIA Syan, R., Dallas, K., Sohlberg, E., Rogo-Gupta, L., Elliott, C., Enemchukwu, E. WILEY. 2018: S567
  • Tibial Nerve and Sacral Neuromodulation in the Elderly Patient Curr Bladder Dysfunct Rep Sohlberg, E., Greenberg, D., Enemchukwu, E. 2018 ; 288 (13)
  • Racial and Socioeconomic Disparities in Short-term Urethral Sling Surgical Outcomes UROLOGY Dallas, K. B., Sohlberg, E. M., Elliott, C. S., Rogo-Gupta, L., Enemchukwu, E. 2017; 110: 70–75

    Abstract

    To evaluate the association of racial and socioeconomic factors with the risk of adverse events in the first 30 days following urethral sling placement.We accessed nonpublic data from the Office of Statewide Health Planning and Development in California from 2005 to 2011. All female patients who underwent an ambulatory urethral sling procedure in the entire state of California over the study period were identified (Current Procedural Terminology 57288). Our main outcome was any unplanned hospital visits within 30 days of the patient's surgery in the form of an inpatient admission, revision surgery, or emergency department visit.A total of 28,635 women who underwent outpatient urethral sling placement were identified. Within 30 days, 1628 women (5.7%) had at least 1 unplanned hospital visit. In the adjusted multivariate model, black race and Medicaid insurance status were both independently associated with increased odds of having an unplanned hospital visit (odds ratio 1.80, P < .01 and odds ratio 1.53, P < .01, respectively). This significance persisted even when controlling for patient comorbidities, demographics, and facility characteristics.We found that, similar to what has been reported in other fields, disparities in outcomes exist between socioeconomic and racial groups in the field of urogynecology.

    View details for PubMedID 28847692

  • CO2 Laser Treatment is Effective for Symptoms of Vaginal Atrophy JOURNAL OF UROLOGY Anger, J. T., Enemchukwu, E. A. 2017; 198 (6): 1229–30

    View details for DOI 10.1016/j.juro.2017.09.003

    View details for Web of Science ID 000417150900004

    View details for PubMedID 29061287

  • THE EFFECT OF MIXED URINARY INCONTINENCE ON CATHETERIZATION RATE AFTER INTRADETRUSOR ONABOTULINUMTOXINA: IS STRESS INCONTINENCE PROTECTIVE? Glass, D., Hoffman, D. S., Enemchukwu, E. A., Brucker, B. M., Nitti, V. W. WILEY-BLACKWELL. 2017: S149–S150
  • Abdominal Imaging Following Urinary Reconstruction: Recommendations and Pitfalls CURRENT BLADDER DYSFUNCTION REPORTS Davenport, M. T., Enemchukwu, E. A. 2016; 11 (4): 291–99
  • EFFICACY AND TOLERABILITY OF MIRABEGRON IN MULTIPLE SCLEROSIS: A PROSPECTIVE Rude, T. L., Enemchukwu, E., Sammarco, C., Nitti, V., Brucker, B. WILEY-BLACKWELL. 2016: S49
  • MANAGEMENT OF PATIENTS SEEKING REVISION OF ANTI-INCONTINENCE SLING:OUTCOMES OF URETHROLYSIS VS. PARTIAL EXCISION Drain, A., Enemchukwu, E., Nitti, V., Brucker, B. Society of Urodynamics and Female Pelvic Medicine and Urogenital reconstruction. 2016
  • DIAGNOSIS OF GENITOURINARY FISTULAE Textbook of Female Urology and Urogynecology Brucker, B., Enemchukwu, E. 2016
  • Transvesical Repair of Vesicovaginal Fistula Hinman's Atlas of Urologic Surgery Rosenblum, N., Enemchukwu, E. 2016
  • Autologous Pubovaginal Sling for the Treatment of Concomitant Female Urethral Diverticula and Stress Urinary Incontinence. Urology Enemchukwu, E., Lai, C., Reynolds, W. S., Kaufman, M., Dmochowski, R. 2015; 85 (6): 1300-1303

    Abstract

    To describe our experience with concomitant repair of urethral diverticula and stress urinary incontinence (SUI) with autologous pubovaginal sling (PVS).A retrospective chart review between January 2006 and 2013 identified 38 women undergoing concomitant diverticulectomy and rectus sheath PVS. Patient demographics, presenting symptoms, prior urethral surgery, concomitant procedures, postoperative outcomes, and complications were evaluated.The mean duration of symptoms was 56.7 months. Eleven patients presented with recurrent diverticula and 5 patients had prior SUI surgery (3 midurethral slings, 1 PVS, and 1 bulking agent). One patient had a prior urethrolysis. All other slings were cut or excised at the time of surgery. All women had demonstrable SUI on cough stress test or urodynamics. The mean follow-up was 12.7 months. All postoperative voiding cystourethrograms were negative for contrast extravasation. One patient required prolonged (>4 weeks) suprapubic tube drainage for urinary retention. Four others required an additional 1 week of suprapubic tube drainage. Eighteen patients (47%) reported mixed urinary symptoms. Of these, 9 had complete resolution, whereas 9 experienced significant improvement. Overall, 97.3% reported resolution of their dysuria, dyspareunia, and pain symptoms and 90% reported complete resolution of their SUI symptoms. There were 2 urethral diverticula recurrences and 2 SUI recurrences. Perioperative complications, including hemorrhage, sling erosion, or urethrovaginal fistulas, were not observed.Concomitant PVS placement is a safe and effective treatment option for SUI in patients undergoing urethral diverticulectomy. The risks and benefits should be weighed and management individualized.

    View details for DOI 10.1016/j.urology.2015.02.022

    View details for PubMedID 26099875

  • Comparative Revision Rates of Inflatable Penile Prostheses Using Woven Dacron (R) Fabric Cylinders JOURNAL OF UROLOGY Enemchukwu, E. A., Kaufman, M. R., Whittam, B. M., Milam, D. F. 2013; 190 (6): 2189-2193

    Abstract

    American Medical Systems (AMS) CX and LGX penile prostheses use woven Dacron® fabric to produce girth, and length and girth expansion, respectively. Cylinder expansion, while desirable, can result in wear of the material which, over time, may lead to device failure. Therefore, we compared girth and length expanding vs girth expanding cylinder survival rates. In addition, we determined the impact of parylene coating on penile prosthesis revision performed for mechanical reasons.All patient information forms from AMS 700™ CX and LGX/Ultrex penile prosthesis implantation performed in the United States from January 1997 through August 2008 were retrospectively analyzed (55,013). Device failure was defined as time to first revision. Survival rates of the 2 groups were analyzed and compared, and survival curves were generated.AMS 700 Ultrex/LGX parylene and CX parylene devices demonstrated equivalent estimated survival rates (88.7% vs 89.5%, respectively, log rank p=0.6811). The parylene coated CX and Ultrex/LGX devices outperformed the nonparylene coated devices on survival analysis.This analysis demonstrated no significant difference in 7-year survival between current generation girth expanding (700 CX) and length and girth expanding (700 LGX/Ultrex) prostheses. This analysis also demonstrated that the parylene coating of the cylinder wall contact surfaces significantly reduced the revision rate of the 700 CX and 700 LGX/Ultrex inflatable penile prostheses.

    View details for DOI 10.1016/j.juro.2013.06.112

    View details for Web of Science ID 000327441000077

    View details for PubMedID 23845458

  • Safety and Efficacy of Sling for Persistent Stress Urinary Incontinence After Bulking Injection UROLOGY Koski, M. E., Enemchukwu, E. A., Padmanabhan, P., Kaufman, M. R., Scarpero, H. M., Dmochowski, R. R. 2011; 77 (5): 1076-1080

    Abstract

    To evaluate the impact of injectable agents on subsequent incontinence surgery outcomes to assess safety and efficacy of this treatment combination. Periurethral bulking agents are a minimally invasive treatment option for stress urinary incontinence (SUI), but often lack durability necessitating further surgical intervention.Retrospective review of 43 patients with SUI following bulking agent who underwent subsequent sling placement from November 2000 to September 2009 were evaluated for demographics, symptoms, urodynamics (UDS), bulking agent characteristics, concomitant procedures, pad requirements per day (PPD), subjective outcomes, and complications.Mean patient age was 67 years, with mean follow-up of 37.3 months. All demonstrated SUI, and mixed urinary incontinence (MUI) was noted in 81.4%. Almost half (48.8%) had undergone a prior antiincontinence procedure. Mean number of injections was 3. After a bulking injection, 25 autologous fascia pubovaginal slings, 13 midurethral slings, and 5 biological pubovaginal slings were placed. Concomitant pelvic surgery was performed in 37.2%. Postoperatively, mean PPD decreased from 5.3 to 0.65, with a 60.5% subjective cure rate (no pads or leakage under any circumstances). No association was seen between number or type of injection, or type of sling with regards to patient outcomes. Results were significantly related to concomitant surgery (P = .007). SUI recurred in 8 patients (18.6%), which was not statistically associated with other parameters. Complications included urinary retention (8 patients) de novo urgency (1 patient), UTI (4 patients), abdominal wound infection (3 patients), and cystotomy (1 patient).Prior treatment with bulking agents does not appear to negatively affect outcomes for future antiincontinence surgery in our patient population.

    View details for DOI 10.1016/j.urology.2010.10.010

    View details for Web of Science ID 000290026700016

    View details for PubMedID 21216448